Kanser Tedavisi Gö ren Çöcuklarda Ağ ız ve Diş Sağ lığ ı

Günümüzde kanser hastalıklarının tedavisinde her ne kadar bilimin ve teknolojinin gelişmesiyle ilerleme sağlanmış olsa da kanser tedavisi halen önemli bir sağlık sorunudur. Kanserli yapıların oluşturduğu defektlerin yanısıra kullanılan ilaçların immunsüpresif ve sitotoksik etkileri orofasiyal yapılarda hasara yol açmaktadır. Oral mukoz membranların kanser tedavilerine oldukça duyarlı olması, çocukların büyüme ve gelişme döneminde olması onkolojik tedavilerin etkilerini arttırmaktadır. Semptomların palyatif tedavisi önem taşımaktadır. Tedavi sırasında ve sonrasında gelişen oral komplikasyonlar ağrı, konuşma ve yutkunma güçlüğü ve beslenme bozukluğu gibi ciddi sorunlara yol açarak hastanın yaşam kalitesini olumsuz etkiler. Bu nedenle pedodontistler, kanser tedavisi nedeniyle ağız ve diş sağlığı komplikasyonlarını azaltmak ve çocuğun yaşam kalitesini artırmak için büyük bir rol oynamaktadır. Bu bildirinin amacı kanser tedavisinden önce, tedavi süresi boyunca ve tedavi sonrasında kapsamlı bir ağız ve diş sağlığı bakımı ile oral komplikasyonların azaltılması ve önlenmesine yönelik güncel bilgilerin sunulmasıdır.

Oral and Dental Health in Children with Cancer Treatment

Today, although the development of science and technology in the treatment of cancer diseases, the treatment of cancer is still an important health problem. In addition to defects caused by cancerous structures, immunosuppressive and cytotoxic effects of drugs used cause damage to orofacial structures. Since oral mucous membranes are very sensitive to cancer treatments and children are in growth/development period, these are increases the effects of oncological treatments. Palliative treatment of symptoms is important. Oral complications that develop during and after treatment cause serious problems such as pain, difficulty in swallowing and speaking, malnutrition, negatively affecting the patient's quality of life. Therefore, pedodontists play a big role for reducing the complications to oral and dental health due to cancer treatment and increasing the quality of life of the child. The aim of this report was to provide comprehensive oral and dental care before, during and after cancer treatment, and up-to-date information on reducing and preventing oral complications.

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1. Korkut E, Esen A, Demiray F et al. Pediatrik Onkoloji Hastalarinda Dental Yaklaşım. Selçuk Tıp Derg. 2016;33:39-44.
2. Özmekik Ö, Ulukapı I. Kemoterapi alan çocuklarda diş hekimliği yaklaşımı. Acta Odontol Turc. 2014;31:154-9.
3. Torre LA, Bray F, Siegel RL, et al. Global cancer statistics 2012. CA: Cancer J Clin. 2015;65:87- 108.
4. Shochat SJ, Fremgen AM, Murphy SB, et al. Childhood cancer: Patterns of protocol participation in a national survey. CA: Cancer J Clin. 2001;51:119-30.
5. Barbería E, Hernandez C, Miralles V, et al. Paediatric patients receiving oncology therapy: review of the literature and oral management guidelines. Eur J Paediatr Dent. 2008;9:188-94.
6. Gurney JG, Davis S, Severson RK, et al. Trends in cancer incidence among children in the US. Cancer. 1996;78:532-41.
7. Arora R, Eden T, Kapoor G. Epidemiology of childhood cancer in India. Indian J Cancer. 2009;46:264-73.
8. Baykara O. Kanser tedavisinde güncel yaklaşımlar. Balıkesir Sağlık Bil Derg. 2016;5:154-65.
9. Gandhi K, Datta G, Ahuja S, et al. Prevalence of oral complications occurring in a population of pediatric cancer patients receiving chemotherapy. Int J Clin Pediatr Dent. 2017;10:166-71.
10. Frascino AV, Fava M, Cominato L, et al. Review of a three-year study on the dental care of oncohematological pediatric patients. Clinics. 2018;73:721-5
11. Kılınç G. Çocuklarda kemoterapi ve radyoterapi ilişkili oral komplikasyonlar. Dokuz Eylül Üni Tıp Fak Derg. 2012;26:75-83.
12. Çakur B, Miloğlu Agdö, Harorli A. Radyoterapi ve kemoterapi gören hastalarda oral bakım. Atatürk Üniv Diş Hek Fak Derg. 2006;16:50-5.
13. Delilbaşı AE. Onkolojik tedavi gören çocuklarda ağız ve diş sağlığı. Acta Odontol Turc. 2013;30:39-43.
14. Yavuz B, Yılmaz HB, Karaman N. Kanserli çocuklarda uluslararası çocuk mukozit değerlendirme ölçeği Türkçe formunun geçerlilik güvenilirlik çalışması. Türk Onkol Derg. 2011;26:157-62
15. El–Housseiny A, Saleh S, El–Masry A, et al. Assessment of oral complications in children receiving chemotherapy. J Clin Pediatr Dent. 2007;31:267-73.
16. Dentistry AAoP. Dental management of pediatric patients receiving immunosuppressive therapy and/or radiation therapy. Pediatr Dent. 2018;40:392-400.
17. Epstein JB, Thariat J, Bensadoun RJ, et al. Oral complications of cancer and cancer therapy: from cancer treatment to survivorship. CA: Cancer J Clin. 2012;62:400-22.
18. Sonis ST, Fey EG. Oral complications of cancer therapy. Oncology. 2002;16:680-95.
19. Hong CH. Considerations in the pediatric population with cancer. Dent Clin North Am. 2008;52:155-81.
20. Supportive PDQ, Palliative Care Editorial B (2002) Oral complications of chemotherapy and head/neck radiation. Bethesda, Md.: National Cancer Institute; Modified December 16, 2016.
21. Kırzıoğlu Z, Tasa T. Kanser tanısı alan çocuk hastalarda oral sağlığın sağlanması. Cumu Dent J. 2018:300-10.
22. Schubert MM, Peterson DE. (2009) Oral complications of hematopoietic cell transplantation. Thomas’ Hema-topoietic Cell Transplantation: Stem Cell Transplantation. 4th ed. Oxford, UK: Wiley-Blackwell.
23. Lalla RV, Brennan MT, Schubert MM. (2011) Oral complications of cancer therapy. Pharmacology and Therapeutics for Dentistry. 6th ed. St. Louis, Mo.: Mosby-Elsevier.
24. Hong CH, Napeñas JJ, Hodgson BD, et al. A systematic review of dental disease in patients undergoing cancer therapy. Support Care Cancer. 2010;18:1007-21.
25. Little J, Miller C, Rhodus N. (2018) Cancer and oral care of patients with cancer. Little and Falace's Dental Management of the Medically Compromised Patient 9th ed St Louis, MO: Elsevier.
26. Yamagata K, Onizawa K, Yanagawa T, et al. A prospective study to evaluate a new dental management protocol before hematopoietic stem cell transplantation. Bone Marrow Transplant. 2006;38:237-42.
27. Saad F, Brown J, Van Poznak C, et al. Incidence, risk factors, and outcomes of osteonecrosis of the jaw: integrated analysis from three blinded activecontrolled phase III trials in cancer patients with bone metastases. Ann Oncol. 2012;23:1341-7.
28. Dodson TB. Intravenous bisphosphonate therapy and bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg. 2009;67:44-52.
29. Peterson D, Boers-Doets C, Bensadoun R, et al. Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment, and follow-up. Ann Oncol. 2015;26:139-51.
30. Stiff PJ, Emmanouilides C, Bensinger WI, Gentile T, Blazar B, Shea TC, et al. Palifermin reduces patient-reported mouth and throat soreness and improves patient functioning in the hematopoietic stem-cell transplantation setting. J Clin Oncol. 2006;24:5186-93.
31. Lalla RV, Bowen J, Barasch A, et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014;120:1453-61.
32. Peterson DE, Öhrn K, Bowen J, et al. Systematic review of oral cryotherapy for management of oral mucositis caused by cancer therapy. Support Care Cancer. 2013;21:327-32.
33. Gøtzsche PC, Johansen HK. Nystatin prophylaxis and treatment in severely immunodepressed patients. Cochrane Database Syst Rev. 2002(4).
34. Amerongen AN, Veerman E. Current therapies for xerostomia and salivary gland hypofunction associated with cancer therapies. Support Care Cancer. 2003;11:226-31.
35. Jensen SB, Pedersen AML, Vissink A, et al. A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer. 2010;18:1039-60.
36. Zahrowski JJ. Bisphosphonate treatment: an orthodontic concern calling for a proactive approach. Am J Orthod Dentofacial Orthop 2007;131:311-20.
37. Dahllöf G, Jönsson A, Ulmner M, Huggare J. Orthodontic treatment in long-term survivors after pediatric bone marrow transplantation. Am J Orthod Dentofacial Orthop. 2001;120:459-65.